British Journal of Radiology (BRIT J RADIOL)

Publisher: British Institute of Radiology, British Institute of Radiology

Journal description

The British Journal of Radiology is the official peer reviewed journal of the British Institute of Radiology covering all clinical and technical aspects of diagnostic imaging, radiotherapy and radiobiology.

Current impact factor: 2.03

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.026
2013 Impact Factor 1.533
2012 Impact Factor 1.217
2011 Impact Factor 1.314
2010 Impact Factor 2.062
2009 Impact Factor 2.105
2008 Impact Factor 2.366
2007 Impact Factor 1.773
2006 Impact Factor 1.279
2005 Impact Factor 1.394
2004 Impact Factor 1.232
2003 Impact Factor 1.089
2002 Impact Factor 0.925
2001 Impact Factor 0.959
2000 Impact Factor 0.951
1999 Impact Factor 1.067
1998 Impact Factor 0.867
1997 Impact Factor 0.811
1996 Impact Factor 0.794
1995 Impact Factor 0.675
1994 Impact Factor 0.766
1993 Impact Factor 0.694
1992 Impact Factor 0.671

Impact factor over time

Impact factor

Additional details

5-year impact 1.98
Cited half-life 9.20
Immediacy index 0.30
Eigenfactor 0.01
Article influence 0.67
Website British Journal of Radiology website
Other titles British journal of radiology, BJR
ISSN 0007-1285
OCLC 1537310
Material type Periodical
Document type Journal / Magazine / Newspaper

Publisher details

British Institute of Radiology

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On funder's repositories, institutional repository or subject-based repositories
    • Publisher's version/PDF can be used on non-commercial open access repositories
    • Published source must be acknowledged
    • Must link to publisher version
    • Authors retain copyright
    • Author copyright and source must be acknowledged with full citation and set statement (see policy)
    • Non-commercial use
    • Publisher last contacted on 20/06/2013
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Recent papers have demonstrated that subchondral insufficiency fractures of the femoral head (SIF) can occur following internal fixation of femoral neck fractures (FNFs), in addition to post-traumatic osteonecrosis of the femoral head (ON). The purpose of this study was to determine clinical and imaging features of SIF after internal fixation of FNFs compared with those of post-traumatic ON. Methods: We reviewed 5 hips in 5 patients, who received internal fixation for the treatment of FNF, and were diagnosed as having SIF according to the shape of the low-intensity band on the T1-weighted MR image. Four hips of 4 patients with post-traumatic ON were compared with the SIF cases. Both the clinical and imaging findings were investigated. Results: There were no significant differences in the age, sex, body mass index, stage of FNF or duration from injury to surgery between SIF and post-traumatic ON. Regarding the prognosis, one of the five cases (20%) with SIF underwent prosthetic replacement due to a progressive collapse of the femoral head. Two of the four cases (50%) with post-traumatic ON underwent prosthetic replacement. Conclusion: The results of this study suggest that SIF should be considered a possible condition following internal fixation of FNFs, and it is important to differentiate SIF from post-traumatic ON. Advances in knowledge: SIF should be considered a possible condition following internal fixation of FNFs.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: The past decade has brought increasing coverage in the medical literature and lay media of the potential association between low-level radiation from diagnostic imaging and an increased lifetime cancer risk. Both physician and public opinion increasingly favour a greater discussion of benefit and risk with patients and their families when such imaging is being considered. Particular attention has been directed towards computed tomography, its use in children, and the emergency department setting. We will review the evolution of radiation dose awareness and knowledge among emergency physicians alongside the parallel increase in public awareness. We will then discuss expectations for risk disclosure and the challenges faced by emergency physicians and radiologists as we strive to provide this in a clinically balanced and meaningful way.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: Objective: To identify the MRI parameters which best predicts complete response (CR) to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC) and to assess their diagnostic performance. Methods: This was a prospective study of pre and post CRT MRI and diffusion weighted imaging (DWI) of 64 patients with LARC who underwent neoadjuvant CRT and subsequent surgery. Histopathological tumour regression grade (TRG) was the reference standard. Multi-variate regression analysis was performed to identify the best MRI predictors of complete response to neoadjuvant CRT and their diagnostic performance was assessed. Results: The study cohort comprised of 48 males and 16 females (n=64) with mean age of 49.48 +/-14.3 years, range of 23-74 years. Eleven patients had pathological complete response (pCR). Low pre-CRT tumour volume on T2W high resolution images and DWI, tumour volume reduction rate of >95% on DWI and CR on post CRT DWI (ydwiT0) as assessed by radiologist predicted CR in univariate analysis. However, the best MRI predictors of CR on multi-variate regression analysis were complete response on post CRT DWI (ydwiT0) as assessed by radiologist and tumour volume reduction rate (TVRR) of > 95% on DWI and these parameters had an area under the curve (AUC) (95% CI) of 0.881(0.74-1.0) and 0.843(0.7-0.98) respectively. The sensitivity, specificity, PPV, NPV and accuracy of DWI in predicting CR was 81.8%, 94.3%, 75%, 96.1% and 76%; the sensitivity, specificity and accuracy of TVRR of >95% as a predictor of complete response was 80%, 84.1% and 64.1% respectively, however, this difference was not statistically significant. The inter-observer agreement was substantial for ydwiT0. Conclusion: Visual assessment of CR on post-CRT DWI and TVRR of >95% on DWI were the best predictors of CR after neo-adjuvant CRT in patients with LARC and the former being more practical can be used in daily practice. Advances in knowledge: In rectal cancer, ydwiT0 as assessed by the radiologist was the best and the most practical imaging predictor of complete response and scores over standard T2w HR images.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: Describe an approach to retrorectal/presacral mass evaluation on imaging with attention to imaging features allowing for refinement of the differential diagnosis of these masses. Elaborate on clinically relevant features that may affect biopsy or surgical approach, of which the radiologist should be aware. Methods: A review of current literature regarding diagnosis and treatment of retrorectal/presacral masses was performed with attention to specific findings which may lend refinement of the differential diagnosis of these masses. Cases were obtained by searching through a current database at a single institution after IRB approval. Results: Recent advances in imaging and treatment methods have led to increased role of radiology in both imaging and tissue diagnosis of retrorectal masses. Surgical philosophies surrounding treatment of these masses have not significantly changed in recent years but there are a few key factors of which the radiologist must be aware. Conclusions: The radiologist can offer refinement of the differential diagnosis of retrorectal masses and can elaborate on salient findings which could alter the need for neoadjuvant chemoradiation therapy, presurgical tissue diagnosis, and surgical approach. Advances in Knowledge: This paper presents an imaging approach to retrorectal/presacral masses with emphasis on findings which can dictate ultimate need for neoadjuvant therapy, presurgical tissue diagnosis and alter the preferred surgical approach. This paper consolidates key findings so radiologists can become more clinically relevant in evaluation of these masses.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: The aim of this paper is to explore the evidence for the revised EU basic safety standard (BSS) radiation dose limits to the lens of the eye, in the context of medical occupational radiation exposures. Publications in the open literature have been reviewed in order to draw conclusions on the exposure profiles and doses received by medical radiation workers and to bring together the limited evidence for cataract development in medical occupationally exposed populations. The current status of relevant radiation protection and monitoring practices and procedures is also considered. In conclusion, medical radiation workers do receive high doses in some circumstances, and thus working practices will be impacted by the new BSS. However, there is strong evidence to suggest that compliance with the new lower dose limits will be possible, though education and training of staff alongside effective use of personal protective equipment will be paramount. A number of suggested actions are given with the aim of assisting medical and associated radiation protection professionals in understanding the requirements.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: The aim of this study is to determine which physical delivery parameter changes are most suitable for multiple level dose painting treatment plans with Helical Tomotherapy (HT). Methods: A total of 96 treatment plans were generated for 12 patients who had undergone 18F-FDG-PET/CT ([18-F]fluoro-2-deoxy-D-glucose positron emission tomography [18F-FDG-PET]) scan to plan head and neck cancer treatment. Based on these PET-CT images, the dose was escalated to 96 Gy in 32 fractions as a function of PET intensity values. The intensity-based prescription was converted into 7 discrete dose levels. For the same patient, different HT plans were optimized by varying parameters such as field width (FW), pitch (PF) and modulation factor (MF). Dose conformity was evaluated using quality volume histograms (QVHs), quality factors (QFs), weighted index of achievement (IOAw), coldness (IOCw) and hotness (IOHw). Moreover, doses to organs at risk (OAR), target volumes and execution time were analyzed. Results: Median QFs were the best for FW=1.05 cm (QF=2.10) and the worst for FW=2.5 cm (QF=3.04). The same trend was observed for IOAw, IOCw and IOHw. Combination of FW=1.05 cm and MF=5 leads to the longest beam-on time (above 25 minutes), whereas FW=2.5 cm and MF=3 to the shortest time (below 8 minutes). Data analyzed based on DVH showed that changes in FW had the strongest impact on plan quality, whereas the effect of MF and PF changes was moderate. Conclusions: HT is suitable for multiple level dose painting treatment plans. Advances in knowledge: Changes in field width and modulation factor had the greatest impact on dose distribution quality and beam-on time. Changes in PF only influenced doses to OARs.
    No preview · Article · Feb 2016 · British Journal of Radiology
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    ABSTRACT: Objective: The purpose of this study is to evaluate the distribution of endplate edema in different types of Modic change especially in mixed type and to analyze the presence of endplate sclerosis in various types of Modic change. Materials and methods: 276 patients with low back pain were scanned with 1.5T MRI. 3 radiologists assessed the MR images by T1-weighted, T2-weighted and fat-saturation T2-weighted sequences and classified them according to the Modic changes. Pure edematous endplate signal changes were classified as Modic type I, pure fatty endplate changes as Modic type II, and pure sclerotic endplate changes as Modic type III. A mixed feature of both type I and II with predominant edematous signal change is classified as Modic I-II, and a mixture of type I and II with predominant fatty change is classified as Modic II-I. Thus, the mixed types can be furtherly subdivided into 7 subtypes, type I-II, type II-I, type I-III, type III-I, type II-III, type III-II and type I-II-III. During the same period, 52 of 276 patients who underwent CT and MRI were retrospectively reviewed to determine endplate sclerosis. Results: Endplate edema: Of the 2760 endplates (276 patients) examined 302 endplates showed Modic changes of which 82endplates showed mixed Modic changes .The mixed Modic changes contain 92.7% of edematous changes. The mixed types especially type I-II and type II-I made the majority of endplate edematous changes. Endplate sclerosis: 52 patients of 276 patients were examined by both MRI and CT. Of 520 endplates 93 showed Modic changes, of which 34 endplates have shown sclerotic changes in CT images.11.8% of 34 endplates have shown Modic type I, 20.6% of 34 endplates have shown Modic type II, 2.9% of 34 endplates have shown Modic type III, and 64.7% of 34 endplates have shown mixed Modic type. Conclusion: Endplate edema makes up the majority of mixed types especially type I-II and type II-I. The endplate sclerosis on CT images may not just mean Modic type III but do exist in all types of Modic changes, especially in mixed Modic types, and may reflect the vertebral body mineralization rather than the change in the bone marrow. Advances in knowledge: Endplate edema and endplate sclerosis are present in large proportion of mixed types.
    No preview · Article · Feb 2016 · British Journal of Radiology

  • No preview · Article · Jan 2016 · British Journal of Radiology

  • No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: To assess the risks of induction of breast tumours from frequent screening mammography in younger women. Methods: A study group of 853 women was identified who had at least 5 mammograms starting before 37 years of age, with 4 or more before age 40. These were followed up from their 40(th) birthday or 8 years from their first mammogram, and their cancer incidence was compared with that of a control group of 1103 women who had an average of 5 mammograms between the ages of 40 and 46. All women in the study were previously assessed to be at moderate familial risk or higher. Results: There were 43 incident breast cancers in the study group after the 8-year start point whereas 38.3 were expected from life table calculations (RR 1.12; 95% CI 0.83 to 1.51). In the control group 50 incident breast cancers developed some time after their first mammogram in follow up to age 60. The observed: expected ratio from life tables in this group was 0.94 (95% CI 0.71-1.24), similar to that in the study group. Conclusions: There was no trend to greater cancer incidence in those receiving mammograms earlier. Advances in knowledge: This study shows that there is no substantial effect on the induction of additional primary breast tumours from frequent mammography starting aged <37 years. Further work on larger numbers of women is necessary to assess longer term risks and determine whether a small excess cancers effect may be present.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: Computed Tomography (CT) examination prior to emergency laparotomy has become ubiquitous in contemporary clinical practice, but the relative accuracy of CT in this context has not been widely reported. The aim of this study was to determine the accuracy and strength of agreement between the perceived pre-operative CT diagnosis and operative findings. Methods: Data from patients undergoing pre-operative CT prior to emergency laparotomy from January 2013 to June 2014 in a large teaching hospital were analysed. The CT diagnosis was compared with operative findings using the chi-squared test and weighted Kappa statistic (Kw). Results were further analysed related to the time of day the CT was reported, the anatomical location and the grade of the reporting radiologist. Results: Three hundred and sixty-one patients [median age 67 (18-98), 180 male] underwent CT prior to emergency laparotomy. CT reports were deemed accurate in 318 (88.1%), and inaccurate in 43 cases (11.9%), which resulted in 5 negative laparotomies in this latter cohort (11.6%, Chi(2) 37.50, df 1, p<0.0001). Accuracy and strength of agreement varied with anatomical location of the pathology; Upper GI (UGI) 75.5%, Kw 0.673 (0.531-0.815, p<0.001); small bowel 89.9%, Kw 0.781 (0.687-0.875, p<0.001); Lower GI (LGI) 90.4%, Kw 0.821 (0.749-0.893, p<0.001). CT examinations reported within normal working hours had higher strength of agreement [Kw= 0.832 (0.768-0.896), p<0.001] than CTs reported out-of-hours [Kw 0.789 (0.721-0.857), p<0.001] but there was no significant difference in overall accuracy (89.9 vs 86.0%; Chi(2) 1.306, df 1, p=0.253). Reporter seniority was not associated with improved diagnostic accuracy (Chi(2) 1.825, df 1, p=0.177). Conclusions: CT agreement with emergency operative pathology was good to excellent, but the strength of agreement varied in relation to anatomical location of pathology. Advances in knowledge: Overall accuracy was 88.1% with good to excellent agreement between pre-operative CT and emergency laparotomy findings in adult patients with non-traumatic abdominal pain in the acute setting. Diagnostic accuracy of CT reporting varies with anatomical location of pathology.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Cardiac Computed Tomography (cardiac-CT) has developed into a robust clinical tool during the past 15 years. Of the fields in which the potential of cardiac-CT has raised more interest is Chest Pain in acute settings. In fact, the possibility to exclude with high reliability obstructive coronary artery disease (CAD) in low-to-intermediate patients is of great interest both from the clinical standpoint and from the management standpoint. Several other modalities, with or without imaging, have been used during the past decades in the settings of new onset chest pain or in acute chest pain for both diagnostic and prognostic assessment of CAD. Each one has advantages and disadvantages. Most imaging modalities also focus on inducible ischemia to guide referral to invasive coronary angiography. The advent of cardiac-CT has introduced a new practice diagnostic paradigm, being the most accurate noninvasive method for identification and exclusion of CAD. Furthermore, detection of subclinical CAD and plaque imaging offer the opportunity to improve risk stratification. Moreover, recent advances of the latest generation CT scanners allow to combine both anatomical and functional imaging by stress myocardial perfusion. The role of cardiac-CT in acute settings is already important and will become progressively more important in the coming years.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objective: Satisfactory radiotherapy treatment requires quality control (QC) of the equipment as well as patient-specific checks. Increased complexity and extended use of equipment plus greater demand for complex treatment has brought pressure on QC resources. The benefits of integrating patient-specific checks and QC and the efficient use of resources is examined. Methods: A non-linear model for the probability of undetected machine failure is proposed which enables the comparative efficiency of resource to be assessed. Benefits of adopting an integrated view of patient-specific and treatment machine QC is considered, considering performance tolerance levels in the context of measurement uncertainty and patient-specific tolerances. Results: Essential, machine-only QC is identified. A realistic approach to equipment-only QC is identified for 70% efficient use of resources and a relationship established to determine resource required for a QC programme. Integration of patient-specific and equipment QC is shown to half the resource required for equipment QC. Conclusion: Increasing benefit from QC requires greater resource, working at lower efficiency. A pragmatic approach is having guaranteed checks supplemented with additional, non-guaranteed checks performed within an integrated approach to machine- and patient-specific QC, bearing in mind the occasions when machine-only QC is essential. Advances in knowledge: The work reveals on a quantitative basis a rational approach to accommodating the QC requirements for safe and effective treatment.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objective: To compare HDR brachytherapy systems with (192)Ir, (60)Co, and electronic brachytherapy source (EBS) for treatment of endometrial cancers. Methods: Two additional plans were generated per patient fraction using (60)Co and Xoft-EBS sources on 10 selected patients, previously treated with a vaginal cylinder applicator using (192)Ir source. Dose coverage of a "PTV_CYLD", a 5 mm shell surrounding the cylinder, was evaluated. The doses to the following organs at risk (OARs) of rectum, bladder and sigmoid were evaluated in terms of V35% and V50%, the percentage volume receiving 35% and 50% of the prescription dose, respectively and D2cc, highest dose to a 2 cubic centimeter volume of an OAR. Results: Xoft-EBS reduces doses to all OARs in the lower dose range but it does not always provide better sparing of the rectum in higher dose range as evaluated using D2cc. V150% and V200% for PTV_CYLD was up to 4 times greater for Xoft-EBS plans compared to plans generated with (192)Ir or (60)Co. Surface mucosal (vaginal cylinder surface) doses were also 23% higher for Xoft-EBS compared to (192)Ir or (60)Co plans. Conclusions: Xoft-EBS is a suitable HDR source for vaginal applicator treatment with advantages of reducing radiation exposure to the organs at risk in the lower dose range while simultaneously increasing the vaginal mucosal dose. Advances in knowledge: This work presents newer knowledge in dosimetric comparison between (192)Ir, or (60)Co and Xoft-EBS sources for endometrical vaginal cylinder HDR planning.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: To evaluate radiation techniques in the treatment of Hodgkin's Lymphoma (HL) and Non-Hodgkin's Lymphoma (NHL) with mediastinal disease over 10-year period, and the toxicity. Methods: Between 2003-2015, 173 patients (pts) with stage I-III nodal lymphoma were treated in our institution: some of these patients were irradiated for HL or NHL with mediastinal disease. Some of the patients were treated by 3DCRT, others by IMRT. Results: We studied 26 men and 43 women with a median age of 26 years. The median follow-up was 43 months. Forty nine pts were treated by 3DCRT and 20 pts-by IMRT. The median dose received by patients treated for NHL was 40 Gy (range: 36-44 Gy) and the median dose received by pts with HL was 30 Gy (range: 30-36 Gy). Between 2003-2006, 16 pts were treated by 3DCRT vs. 0 by IMRT. Between 2007-2009, 16 pts received 3DCRT and 1-IMRT. Between 2010-2015, 19 pts received IMRT, and no patients 3DCRT. Eleven of the 20 patients (55%) treated by IMRT and 35/49 pts (71.4%) treated by 3DCRT experienced acute toxicity. Among the patients treated by 3DCRT, 1 patient experienced grade 1 radiation pneumonitis and 2 patients experienced grade 1 acute mucositis. No late toxicity was observed in the patients treated by IMRT. Conclusions: Improvement of radiation techniques for HL and NHL appears to have improved acute and late clinical safety. Longer follow-up is necessary to evaluate very late toxicity. Advances in knowledge: Improvement of radiation techniques for HL and NHL appears to improving the tolerance.
    No preview · Article · Jan 2016 · British Journal of Radiology
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    ABSTRACT: Objectives: To evaluate breast lesion spatial displacement from prone MR to supine US positions and to determine whether the degree of displacement may be associated with breast density and lesion histotype. Methods: 380 patients underwent breast MR and second look US. The MR and US lesion location within the breast gland, distances from anatomical landmarks (nipple, skin, pectoral muscle), spatial displacement (distance differences from the landmarks within the same breast region) and region displacement (breast region change) were prospectively evaluated. Differences between MR and US measurements, association between the degree of spatial displacement and both breast density and lesion histotypes were calculated. Results: In 290/380 (76%) patients, 300 MR lesions were detected. 285/300 (95%) lesions were recognized on US. By comparing MR and US, spatial displacement occurred in 183/285 (64.3%) cases while region displacement in 102/285 (35.7%) with a circumferential movement along an arc centred on the nipple, having the supine US as the reference standard. A significant association between the degree of lesion displacement and breast density was found (p<0.00001) with a significant higher displacement in case of fatty breasts. No significant association between the degree of displacement and lesion histotype was found (p=0.1). Conclusions: Lesion spatial displacement from MRI to US may occur especially in the adipose breasts. Lesion-nipple distance and circumferential displacement from the nipple need to be considered for US lesion detection. Advances in knowledge: Second look US breast lesion detection could be improved by calculating the lesion-nipple distance and considering that spatial displacement from MRI occurs with a circumferential movement along an arc centred on the nipple.
    No preview · Article · Dec 2015 · British Journal of Radiology
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    ABSTRACT: PURPOSE: The purpose was to evaluate individually shaped contrast media (CM) delivery in CT pulmonary angiography (CTPA) for suspected pulmonary embolism. MATERIALS AND METHODS: 100 consecutive emergency patients with clinical suspicion for pulmonary embolism were evaluated. High-pitch CTPA was performed on a 2nd generation dual-source CT using the following parameters: 100kV, 200-250mAsref, rot.time 0.28s, 128x0.6mm col., image reconstruction 1.0/0.8mm (B30f). Group 1 (n=50) then received a fixed CM bolus (300mgI/ml, volume=90ml, flow rate=6ml/s); group 2 (n=50) received a body weight adapted CM bolus determined by dedicated contrast injection software. For analysis, groups were further subdivided into low (40-75kg) and high (76-117kg) weight groups. Technical image quality was graded using a four-point Likert scale (1=non-diagnostic; 2=diagnostic; 3=good and 4=excellent image quality) at the level of the pulmonary trunk and pulmonary arteries. Objective image quality analysis was done measuring contrast enhancement in Hounsfield units (HU) at the same levels. Attenuation levels >180HU were considered diagnostic. RESULTS: All examinations were graded diagnostic at each level. The individual minimum pulmonary attenuation was 184HU and 270HU for group 1 and 2, respectively. Mean attenuation was as follows: group 1: 475±105HU (40-75kg) and 402±115HU (76-117kg), p<0.03. Group 2: 424±76HU (40-75kg) and 418±100HU (76-117kg), p=0.8. For group 2, CM volumes were: 55±5ml (40-75kg) and 66±5ml (76-117kg), leading to a 16-51% CM reduction. CONCLUSION: Even under emergency conditions, individualised CM protocols can provide diagnostic and robust image quality in CTPA for pulmonary embolism with a substantial reduction of CM volume for lower weight patients, compared to a fixed CM protocol. Advances in Knowledge: CM volume can substantially be reduced by using individualised CM protocols in CTA for pulmonary embolism without compromising diagnostic image quality.
    No preview · Article · Dec 2015 · British Journal of Radiology
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    ABSTRACT: Objectives: To use a Likert scale method to optimise image quality (IQ) for cone-beam CT (CBCT) soft-tissue matching for image-guided radiotherapy of the prostate. Methods: 23 men with local / locally advanced prostate cancer had the CBCT IQ assessed using a 4 point Likert scale (4 = Excellent, no artefacts; 3 = Good, few artefacts; 2 = Poor, just able to match; 1 = Unsatisfactory, not able to match) at 3 levels of exposure. The lateral separations of the subjects were also measured. The Friedman test and Wilcoxon signed rank tests were used to determine if the IQ was associated with the exposure level. We used the point-biserial correlation and a chi-squared test to investigate the relationship between the separation and IQ. Results: The Friedman test showed that the IQ was related to exposure (p=2x10(-7)) and the Wilcoxon signed rank test demonstrated that the IQ decreased as exposure decreased (all p values < 0.005). We did not find a correlation between the IQ and the separation (correlation coefficient 0.045), but for separations less than 35 cm it was possible to use the lowest exposure parameters studied. Conclusions: We can reduce exposure factors to 80% of those supplied with the system without hindering the matching process for all patients. For patients with lateral separations less than 35 cm the exposure factors can be reduced further to 64% of the original values. Advances in knowledge: Likert scales are a useful tool for measuring IQ in the optimisation of CBCT IQ for soft tissue matching in radiotherapy image guidance applications.
    No preview · Article · Dec 2015 · British Journal of Radiology